News from NASADAD

• NPN announces call for 2016 National Exemplary Awards applications

News from the States

• CDC issues report examining fentanyl-related drug overdose deaths in Ohio
• Kansas passes juvenile justice reforms, shifting focus from detention centers to community-based programs

Around the Agencies

• CMS finalizes rule on mental health and substance use disorder parity for Medicaid and CHIP
• SAMHSA announces Daryl Kade as CBHSQ Director, Monica Feit as OPPI Director
• HHS releases new guidance on federal funding for syringe service programs

In the News

• NAATP announces new study tracking treatment outcomes data
• National Alliance for Model State Drug Laws updates reports on marijuana legislation
• President Obama announces additional actions to address the opioid crisis

News from NASADAD

NPN announces call for 2016 National Exemplary Awards applications
The National Prevention Network (NPN) has announced their call for applications for the 2016 National Exemplary Awards for Innovative Substance Abuse Prevention Programs, Practices, and Policies. The Exemplary Awards program identifies and honors outstanding achievements in substance abuse prevention throughout the country. The 2016 Awards will recognize exceptional substance abuse efforts and serve to focus national attention on the field of substance abuse prevention. They are intended to showcase “grassroots,” evidence-based substance abuse prevention programs and strategies that have been evaluated and may be replicated by others.  Applications are due Friday, May 6^th, 2016.

Access the 2016 Exemplary Awards application here.

News from the States

CDC issues report examining fentanyl-related drug overdose deaths in Ohio
The Centers for Disease Control and Prevention (CDC) has released a report analyzing fentanyl-related drug overdose deaths in Ohio. Ohio’s Department of Health had previously requested assistance from the CDC after data suggested fentanyl-related overdose deaths increased from 84 in 2013 to 502 in 2014. The CDC’s investigation examined death certificates, medical examiner reports, emergency department visit data, and prescription history data from the Ohio Automated Rx Reporting System, the State’s prescription drug monitoring program (PDMP). Results from the study indicate that individuals experiencing fentanyl-related overdose deaths are 69 percent male, 89 percent white, and 94 percent with some college or less education. The average age of those experiencing fentanyl overdoses was 37.9 years old. The study recommends that counties continue to monitor fentanyl-related deaths and perform targeted interventions as necessary. The CDC suggests improving access to naloxone for first responders.

Read the full report here.

Kansas passes juvenile justice reforms, shifting focus from detention centers to community-based programs
The Kansas House of Representatives has passed a bill reforming the State’s juvenile justice system. The bill places larger emphasis on therapeutic treatment options for non-violent juvenile offenders by shifting support from detention centers to community-based programs. Kansas expects the bill to save the State about $72 million in funding over the next five years, as research suggests community-based programs decrease recidivism and increase high school graduation rates. The Kansas State Senate passed a similar measure earlier in the session that phases out Kansas’s use of youth residential facilities by 2018. This phasing out contradicts the House version of the bill that keeps 50 beds available in youth facilities. This disagreement will be negotiated by both chambers before being submitted to Governor Brownback.

Read more about Kansas’s juvenile justice reforms here.

Around the Agencies

CMS finalizes rule on mental health and substance use disorder parity for Medicaid and CHIP
The Centers for Medicare & Medicaid Services (CMS) announced the finalization of a rule related to mental health and substance use disorder parity for Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries last week. The rule was released in conjunction with President Obama’s visit to the National Rx Drug Abuse and Heroin Summit in Atlanta. The rule intends to expand access to evidence-based treatment by providing States flexibility in managed care delivery mechanisms while requiring that Medicaid beneficiaries are able to access mental health and substance use disorder benefits in a similar way to other medical benefits. Plans are required to provide information on mental health and substance use disorder benefits, including determination of medical necessity criteria, under the new rule. States must now disclose the rationale behind any denial of reimbursement for mental health and substance use disorder benefit claims.

View the final rule here.

SAMHSA announces Daryl Kade as CBHSQ Director, Monica Feit as OPPI Director
The Substance Abuse and Mental Health Services Administration (SAMHSA) has announced Daryl Kade as the new Director of the Center for Behavioral Health Statistics and Quality (CBHSQ) and Monica Feit, Ph.D. as Director of the Office of Policy, Planning, and Innovation (OPPI). Ms. Kade and Dr. Feit were both already serving as Acting Directors of both CBHSQ and OPPI, respectively.

As CBHSQ Director, Ms. Kade will provide national leadership in substance use disorder treatment, substance abuse prevention, and mental health statistics. Ms. Kade previously served as Acting Director of the Center for Substance Abuse Treatment (CSAT) and as Director of SAMHSA’s Office of Financial Resources. Ms. Kade has also worked within the Office of National Drug Control Policy (ONDCP) as a budget and legislative analyst.

As OPPI Director, Dr. Feit will assist SAMHSA in policy formulation and implementation in conjunction with external stakeholders. Dr. Feit previously joined the Department of Health and Human Services (HHS) as Director of the Division of Public Health Services in the Office of the Assistant Secretary for Planning and Evaluation (ASPE) in 2013. Before joining HHS, Dr. Feit worked as a Senior Program Officer at the Institute of Medicine (IOM).

HHS releases new guidance on federal funding for syringe service programs
Last week the U.S. Department of Health and Human Services (HHS) released new guidance for State, local, and tribal health departments seeking to fund syringe service programs (SSPs) through federal grant money. The guidance states that health departments are now able to use federal funding to create or enhance SSPs to help prevent the spread of HIV and viral hepatitis. It is important to note that while federal funds can be used for a large array of services, they cannot be used to purchase sterile needles or syringes.

HHS will require that health departments consult with the Centers for Disease Control and Prevention (CDC) to determine whether there is a need for SSPs in their jurisdiction. Once consulted, CDC will decide whether health departments are eligible to apply for SSP funding from their respective federal agencies.

Read the full guidance document here.

In the News

NAATP announces new study tracking treatment outcomes data
The National Association of Addiction Treatment Providers (NAATP) has announced a new study tracking patient outcomes from residential and outpatient treatment programs. The NAATP will collaborate with the OMNI Institute to collect data from over one-thousand patients following their first year after treatment. The study will examine a number of outcomes, including: detoxification, patient engagement, medication, counseling, peer and family support, and twelve-step activity.

Read the full press release here.

National Alliance for Model State Drug Laws updates reports on marijuana legislation
The National Alliance for Model State Drug Laws (NAMSDL) has updated its series of reports on medicinal, legal, and illegal marijuana legislation for 2016. The reports summarize ongoing and future efforts to regulate both the medical marijuana and legal marijuana industries at the State level. Three reports are now available: a report examining “follow-up” legislation in States that have legalized the personal use of marijuana, a report examining legislation to decriminalize the personal use of marijuana, and a report examining general marijuana legalization efforts.

Read the “follow-up” legislation report here.

Read the decriminalization report here.

Read the personal non-medical use report here.

President Obama announces additional actions to address the opioid crisis
On March 29^th President Obama announced the following policies during a speech at the National Rx Drug Abuse and Heroin Summit:

• HHS will issue a proposed rule increasing the buprenorphine treatment cap from 100 to 200 patients for qualified physicians treating opioid use disorders.
• HHS will release $94 million in new funding to 271 Community Health Centers – expected to help treat approximately 124,000 new patients with substance use disorders.
• SAMHSA will release $11 million in funding opportunities to expand medication-assisted treatment in up to 11 States.
• President Obama will sign a memorandum authorizing the creation of a Mental Health and Substance Use Disorder Parity Task Force to be chaired by the Domestic Policy Council. The Task Force will be held to an October 31 deadline to ensure that important parity protections are implemented.
• HHS will finalize a rule bolstering mental health and substance use disorder parity in Medicaid and CHIP.

For more information, click here.

Should you have any questions, or require additional information, please do not hesitate to contact Robert Morrison, Executive Director, (202) 293-0090 or Shalini Wickramatilake-Templeman, Public Policy Associate, at (202) 293-0090.

President Obama speaks at the 2016 National Rx Drug Abuse and Heroin Summit
President Obama plans to deliver a speech at the 2016 National Rx Drug Abuse & Heroin Summit on 3/29 at 2:15 PM EST. The President’s remarks will discuss the actions currently being taken to prevent the spread of opioid use disorders and will examine future potential policies for expanding access to treatment.

Read more about President Obama’s speech here.

View the speech here.

President Obama Announces Additional Actions to Address the Prescription Opioid Abuse and Heroin Epidemic
President Obama will announce the following policies during today’s speech at the National Rx Drug Abuse and Heroin Summit:

• HHS will issue a proposed rule increasing the buprenorphine treatment cap from 100 to 200 patients for qualified physicians treating opioid use disorders.
• HHS will release $94 million in new funding to 271 Community Health Centers – expected to help treat approximately 124,000 new patients with substance use disorders.
• SAMHSA will release $11 million in funding opportunities to expand medication-assisted treatment in up to 11 States.
• President Obama will sign a memorandum authorizing the creation of a Mental Health and Substance Use Disorder Parity Task Force to be chaired by the Domestic Policy Council. The Task Force will be held to an October 31 deadline to ensure that important parity protections are implemented.
• HHS will finalize a rule bolstering mental health and substance use disorder parity in Medicaid and CHIP.

Other actions are detailed here.

Guidance for Syringe Service Programs (SSPs)
Congress reversed a longstanding ban on the usage of federal funds for SSPs in late 2015. The U.S. Department of Health and Human Services (HHS) recently released new guidance for State, local, and tribal health departments seeking to fund SSPs through federal grant money. The guidance states that health departments are now able to use federal funding to create or enhance SSPs to help prevent the spread of HIV and viral hepatitis. It is important to note that while federal funds can be used for a large array of services, they cannot be used to purchase sterile needles or syringes.

HHS will require that health departments consult with the Centers for Disease Control and Prevention (CDC) to determine whether there is a need for SSPs in their jurisdiction. Once consulted, CDC will decide whether health departments are eligible to apply for SSP funding from their respective federal agencies.

Read the full guidance document here.

CMS finalizes rule dealing with mental health and substance use disorder parity for Medicaid and CHIP
The Centers for Medicare & Medicaid Services (CMS) have announced the finalization of a rule strengthening mental health and substance use disorder parity for Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries. The rule was released in conjunction with President Obama’s visit to the National Rx Drug Abuse and Heroin Summit in Atlanta. The rule intends to expand access to evidence based treatment by providing States flexibility in managed care delivery mechanisms while requiring Medicaid beneficiaries are able to access mental health and substance use disorder benefits in a similar way to other medical benefits. Plans are required to provide information on mental health and substance use disorder benefits, including determination of medical necessity criteria, under the new rule. States must now disclose the rationale behind any denial of reimbursement for mental health and substance use disorder benefit claims. The final rule will be published in the Federal Register on March 30, 2016.

View the final rule here.

News from the States

• Northwest High Intensity Drug Trafficking Area report examines Washington State post-marijuana legalization, finds increased rates of marijuana usage and impaired driving
• Ohio Board of Pharmacy adopts resolution allowing for personal furnishing of naloxone

Around the Agencies

• Department of Veteran Affairs announces full coverage for veterans with hepatitis C for current fiscal year
• CMS releases new tool tracking disparities between Medicare beneficiaries
• NIH study discovers mindfulness meditation engages a different brain pathway than opioids

In the News

• ASAM announces addition of addiction medicine as new medical subspecialty under the American Board of Preventative Medicine
• Health Affairs survey reports $15.4 billion in annual spending by physicians to report quality measures

News from the States

Northwest High Intensity Drug Trafficking Area report examines Washington State post-marijuana legalization, finds increased rates of marijuana usage and impaired driving
The Northwest High Intensity Drug Trafficking Area (NWHIDTA) released a report last week finding increased rates of marijuana usage and impaired driving in the wake of Washington State’s legalization of marijuana. The report states that between 2013 and 2014, forty-eight percent of student expulsions and 42 percent of suspensions directly involved the use of marijuana. Twenty-four percent of individuals aged 18 to 25 reported past-month marijuana usage in 2014, with 17 percent using marijuana weekly and 6 percent using marijuana daily. Marijuana usage among Washington adults was 5 percent higher than the national average between 2012 and 2013. The report further asserts that between 2010 and 2014, the number of drivers with active tetrahydrocannabinol (THC) in their blood during fatal driving accidents increased 122 percent from 16 percent in 2010 to 23 percent in 2014. The NWHIDTA notes that marijuana from Washington State has been found in 43 different States around the country.

Read the full report here.

Ohio Board of Pharmacy adopts resolution allowing for personal furnishing of naloxone
The Ohio Board of Pharmacy adopted a resolution allowing Board-licensed facilities to stock “non-patient specific” naloxone earlier this month. This measure will allow facilities to keep additional doses of naloxone on site in the event of emergency. The regulatory statement notes that this resolution “addresses a concern raised by a number of entities that wanted to have naloxone on-site but could not afford the cost of equipping all staff.”

Read the full resolution here.

Around the Agencies

Department of Veteran Affairs announces full coverage for veterans with hepatitis C for current fiscal year
The Department of Veteran Affairs has announced their ability to cover treatment for veterans with all stages of hepatitis C within the current fiscal year. Secretary David Shulkin noted that the expanded care is the result of both increased Congressional funding and reduced hepatitis C drug prices. The Department of Veteran Affairs was allocated $1 billion for hepatitis C drug purchases in FY 2016, an increase from the $696 million appropriated in FY 2015. The Department of Veteran Affairs has requested $1.5 billion for FY 2017 to continue expanding veterans’ access to hepatitis C treatment.

Read the full story here.

CMS releases new tool tracking disparities between Medicare beneficiaries
The Centers for Medicare & Medicaid Services’ (CMS) Office of Minority Health has released a new tool tracking disparities between Medicare beneficiaries. The tool displays geographic, racial, and ethnic differences in hospitalizations, emergency room visits, and readmissions for chronic conditions. The tool also measures the overall prevalence and variation of chronic conditions. CMS hopes the tool will be used to better understand health outcome disparities throughout the country. KPMG and the National Opinion Research Center (NORC) at the University of Chicago helped develop the tool as part of CMS’s broader plan to improve Medicare quality.

Access the tool here.

NIH study discovers mindfulness meditation engages a different brain pathway than opioids
A National Institutes of Health (NIH) study partially funded by the National Center for Complementary and Integrative Health has discovered that mindfulness meditation engages a separate pain relief brain pathway than opioid pain relievers. This finding provides specific evidence of how mindfulness meditation works to provide pain relief. The study examined four separate treatment groups, finding that participants who meditated during administration of saline or naloxone experienced lower pain intensity than the control groups. The researchers concluded that mindfulness meditation therapy combined with other pharmacologic or non-pharmacologic options may provide new approaches to pain treatment.

Read the full announcement here.

In the News

ASAM announces addition of addiction medicine as new medical subspecialty under the American Board of Preventive Medicine
Earlier this week the American Society of Addiction Medicine (ASAM) celebrated the addition of addiction medicine as a new subspecialty by the American Board of Medical Specialties (ABMS) under the American Board of Preventive medicine. This new inclusion will allow addiction medicine fellowship training programs to be accredited by the Accreditation Council on Graduate Medical Education (ACGME), thereby increasing access to funding for programs bolstering the substance use disorder workforce. ASAM also notes that this development will help to include addiction medicine specialists within health networks. The announcement was the result of more than a decade of work by ASAM members to increase access to treatment and address the substance use disorder workforce.

Read the full press release here.

Health Affairs survey reports $15.4 billion in annual spending by physicians to report quality measures
A new survey published by Health Affairs reports that physicians spent $15.4 billion a year on health quality measure reporting for Medicare, Medicaid, and private health insurance companies between 2014 to 2015. The survey finds that physician practices spend 15 hours a week or more on work related to health quality tracking and reporting. Survey authors note that the majority of the time spent on health quality reporting involves data entry. Eighty percent of the practices surveyed reported spending more resources on quality measurement compared to three years ago, with half of the practices reporting that existing quality measures are time consuming due to frequent duplication of similar measures. The survey recommends that the industry make efforts to standardize quality measures to improve efficiency.

Read the full study here.

Should you have any questions, or require additional information, please do not hesitate to contact Robert Morrison, Executive Director, (202) 293-0090 or Shalini Wickramatilake-Templeman, Public Policy Associate, at (202) 293-0090.